基于超声射频流的RF时间序列信号在乳腺病变良恶性鉴别中的价值

doi:10.3877/cma.j.issn.1672-6448.2016.05.014

目的

探讨基于超声射频流的原始射频（RF）时间序列信号定量分析在乳腺良恶性病变鉴别诊断中的应用。

方法

采用加拿大Ultrasonix Sonix TOUCH超声检查仪，L14-5线阵探头，对137个乳腺病灶最大横切面连续存储10 s二维图像射频RF信号。采用自编的RF时间序列信号分析软件对病灶组织感兴趣区（ROI）进行定量分析，得到9个谱特征参数，即尺寸测量关系（size measure relationship，SMR）分形维数、Higuchi分形维数、谱斜率（Slope）、谱截距（Intercept）、中频（Mid-band fit）和S1，S2，S3，S4。经手术或穿刺活检病理证实86个病灶为恶性，30个病灶为良性，21个病灶经随访2年以上无明显变化确诊为良性。

结果

基于超声射频流的RF时间序列信号的特征参数SMR分形维数、Higuchi分形维数、谱斜率（Slope）、谱截距（Intercept）、中频（Mid-band fit）和S1，S2，S3，S4，在良性病灶中均低于恶性病灶，差异具有统计学意义（0.75±0.77 vs 0.82±0.10，t=-4.722，1.31±0.07 vs 1.42±0.10，t=-7.476，-0.24±0.04 vs -0.26±0.06，t=1.986，0.19±0.03 vs 0.21±0.048，t=-3.391，0.067±0.011 vs 0.08±0.019，t=-5.319，3.22±0.54 vs 3.60±0.83，t=-3.298，0.53±0.12 vs 0.73±0.23，t=-6.467，0.31±0.06 vs 0.45±0.13，t=-9.207，0.24±0.05 vs 0.38±0.12，t=-9.367，P值均<0.05）。

结论

基于超声射频流的RF时间序列信号定量分析有望成为乳腺疾病鉴别诊断简单、无创的影像学新方法。

关键词: 乳腺肿瘤, 超声检查, 诊断，鉴别

Objective

To evaluate the values of RF time-series signal based on ultrasonic radio-frequency flow in the differentiation of benign and malignant breast lesions.

Methods

A commercially available clinical ultrasound scanner, Sonix TOUCH (Ultrasonix Medical Corporation, Richmond, Canada) with a L14–5 linear ultrasound transducer was used to simultaneously collect B-mode images and RF data from breast lesions. The ultrasound probe displaying the maximal plane of the breast lesion was kept in the same position for 10 seconds. The ultrasound RF data from region of interest was imported into software developed by our lab for ultrasound spectral analysis and 9 spectral parameters including SMR fractal dimension, Higuchi fractal dimension, Slope, Intercept, Mid-band fit, S1, S2, S3, S4 were calculated. 137 patients with 137 breast lesions confirmed by pathological or follow-up findings were included in the study. Of the 137 breast lesions, 86 malignant and 30 benign lesions were confirmed by ultrasound guided core needle biopsy or surgical excision, and the rest 21 lesions were presumed benign as no significant change was found after at least 2 years of follow-up.

Results

There are significantly difference in spectral parameters including SMR fractal dimension, Higuchi fractal dimension, Slope, Intercept, Mid-band fit, S1, S2, S3 and S4 between the malignant and benign breast lesions (0.75±0.77 vs 0.82±0.10, t=-4.722, 1.31±0.07 vs 1.42±0.10, t=-7.476, -0.24±0.04 vs -0.26±0.06, t=1.986, 0.19±0.03 vs 0.21±0.048, t=-3.391, 0.067±0.011 vs 0.08±0.019, t=-5.319, 3.22±0.54 vs 3.60±0.83, t=-3.298, 0.53±0.12 vs 0.73±0.23, t=-6.467, 0.31±0.06 vs 0.45±0.13, t=-9.207, 0.24±0.05 vs 0.38±0.12, t=-9.367, all P<0.05).

Conclusion

RF time-series signal based on ultrasonic radio-frequency flow could provide a new imaging method with a simple, low-cost noninvasive technique for the differential diagnosis of the benign and malignant breast lesions.

Key words: Breast neoplasms, Ultrasonography, Diagnosis, differential

图1 二维灰阶超声检查乳腺良性病灶RF时间序列参数提取过程

图2 图像相似的乳腺良恶性病灶RF时间序列信号差异明显

表1 137个乳腺病灶病理类型

病灶性质	例数	病理结果	病灶（个）
恶性	86	浸润性导管癌	79
		浸润性小叶癌	3
		黏液癌	2
		神经内分泌癌	1
		浸润性癌	1
良性	51	纤维腺瘤	14
		导管内乳头状瘤	7
		腺病	7
		需鉴别纤维腺瘤与纤维腺病	1
		炎症改变	1
		随访良性	21

表1 137个乳腺病灶病理类型

病灶性质	例数	病理结果	病灶（个）
恶性	86	浸润性导管癌	79
		浸润性小叶癌	3
		黏液癌	2
		神经内分泌癌	1
		浸润性癌	1
良性	51	纤维腺瘤	14
		导管内乳头状瘤	7
		腺病	7
		需鉴别纤维腺瘤与纤维腺病	1
		炎症改变	1
		随访良性	21

表2 乳腺良恶性病灶基于超声射频流的RF时间序列信号定量分析参数比较表

组别	SMR分形维数	Higuchi分形维数	Slope	Intercept	Midband fit	S1	S2	S3	S4
恶性	0.82±0.10	1.42±0.10	-0.26±0.06	0.21±0.048	0.08±0.019	3.60±0.83	0.73±0.23	0.45±0.13	0.38±0.12
良性	0.75±0.77	1.31±0.07	-0.24±0.04	0.19±0.03	0.067±0.011	3.22±0.54	0.53±0.12	0.31±0.06	0.24±0.05
t值	-4.722	-7.476	1.986	-3.391	-5.319	-3.298	-6.467	-9.207	-9.367
P值	<0.01	<0.01	0.049	0.01	<0.01	0.01	<0.01	<0.01	<0.01

表2 乳腺良恶性病灶基于超声射频流的RF时间序列信号定量分析参数比较表

组别	SMR分形维数	Higuchi分形维数	Slope	Intercept	Midband fit	S1	S2	S3	S4
恶性	0.82±0.10	1.42±0.10	-0.26±0.06	0.21±0.048	0.08±0.019	3.60±0.83	0.73±0.23	0.45±0.13	0.38±0.12
良性	0.75±0.77	1.31±0.07	-0.24±0.04	0.19±0.03	0.067±0.011	3.22±0.54	0.53±0.12	0.31±0.06	0.24±0.05
t值	-4.722	-7.476	1.986	-3.391	-5.319	-3.298	-6.467	-9.207	-9.367
P值	<0.01	<0.01	0.049	0.01	<0.01	0.01	<0.01	<0.01	<0.01

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Differential diagnosis of breast lesions with RF time-series signal based on ultrasonic radio-frequency flow

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Differential diagnosis of breast lesions with RF time-series signal based on ultrasonic radio-frequency flow